Vascular Screenings Can Detect ‘Silent Killers’

Vascular diseases are known as “silent killers” because they often strike without warning.

“Vascular disease refers to changes to the blood vessels outside of the heart,” says Dr. Todd Wood, cardiologist, medical director of the vascular clinic at Penn Medicine Lancaster General Health.

“This can include arteries or veins but most commonly is associated with arteries,” Wood says. “It can involve blood flow to the extremities, brain, or other internal organs. And, it refers to both atherosclerosis (blockages) and aneurysms (dilated blood vessels).”

Vascular diseases are often unaccompanied by symptoms, making it extremely important to catch these diseases before it’s too late. Vascular diseases can result in stroke, loss of limbs, or death. The best way to detect vascular diseases is through vascular screenings.

Stroke, peripheral artery disease, and abdominal aortic aneurysm are the three most serious, non-cardiac-related vascular diseases that afflict Americans.

While men and women can be affected by vascular diseases, the risk increases for men at 40 years of age and older. It can begin earlier, depending on lifestyle factors.

June is National Men’s Health Month, and it’s an ideal time for men to have a vascular screening. According to the Centers for Disease Prevention and Control, most men’s health issues can be prevented when they are detected early.

Wood is a strong advocate of vascular screenings.

“They are not a threat to patients and they are very effective. There are some conditions that progress silently, like abdominal aortic aneurysms — where the first symptom is a medical emergency. An early detection can allow for appropriately timed correction to avoid a potentially life-threatening event.

“Other conditions, when detected, can allow us to know we need to intensify treatment of risk factors to prevent more significant future issues,” he says.

Who should be screened? Anyone over age 55 or anyone over age 40 who has multiple risk factors, including: family history of heart disease or strokes, history of smoking, high blood pressure, overweight, high stress levels, inactive lifestyle, high cholesterol, or diabetes, according to the Brookings Health System.

There are three important diagnostic ultrasound screenings that can be conducted. They are: peripheral arterial ultrasound, carotid artery ultrasound, and abdominal aortic aneurysm ultrasound.

Ultrasound is a noninvasive test. It uses high-frequency sound waves to produce still and moving images of the body.

Here are brief descriptions of the three major vascular-disease screenings:

Peripheral arterial ultrasound: This screening is done to diagnose peripheral artery disease, a circulatory disorder in which arteries narrow and restrict blood flow to the rest of the body. Leg pain and leg cramps are common symptoms of PAD.

During the test, the patient’s blood pressure is taken with a cuff at the arm, thigh, calf, ankle, and toe. An ultrasound device is moved across the area to detect blood flow through the areas before and after the blood pressure is inflated.

PAD affects at least a quarter of those who are 70 years or older.

Carotid duplex ultrasound: Carotid arteries are located on each side of the neck. They supply the brain with blood. When the carotid arteries narrow and get clogged, serious complications, such as stroke and even death, can occur. This screening checks for buildup of fatty blockages, plaque, or other abnormalities.

Stroke is the third leading cause of death in the United States and the No. 1 cause of disability in older people. More than half of all strokes in older adults are due to carotid artery disease.

Abdominal aortic aneurysm ultrasound: An aneurysm is a localized, balloon-like expansion in a blood vessel caused by weak vessel walls. An abdominal aortic aneurysm ultrasound is used to identify any abnormalities, the possible presence of an aneurysm, and how extensive the damage may be.

Physicians can accurately measure the size of the aneurysm to determine the need for treatment. Rupture of an aneurysm is fatal in most cases. Most people, however, don’t know they have an aneurysm. Abdominal aortic aneurysm is the 10th leading cause of death in men over age 50 in the United States.

While vascular screenings are simple and noninvasive, Wood says the major barriers are “lack of awareness and the fact that we tend to be more engaged in getting testing for things that are causing us symptoms than looking for asymptomatic potential problems.”

Having a vascular screening can accomplish more than just providing a snapshot of what is going on with your blood vessels. It can produce other positive results.

Researchers with the Journal of Community Medicine and Health Education studied two groups: one that had received a vascular screening procedure and one that hadn’t. Both groups were surveyed regarding their current health status and future health and lifestyle plans.

Individuals who had received the vascular screenings were more likely to modify their behavior and pursue a healthier lifestyle than those who had not been screened. This was true regardless of the results of the screening.

Despite the availability of vascular screenings, the rates of vascular disease have increased in recent years. Why? Wood attributes it to several factors.

“Two of the main risk factors for peripheral arterial disease are smoking and diabetes,” he says. “While the rates of smoking have declined somewhat, we are facing an epidemic of increasing diabetes. Additionally, we are looking for vascular diseases more, which can make the rates look higher by increased detection.” BW